Introduction
Esophageal cancer (=cancer of the esophagus) is one of the cancers that is difficult to diagnose. The esophagus is hidden deep inside the body between the oral cavity and the stomach. It cannot be easily examined, unless a procedure such as gastroscopy as well as CT and MRI scan technology are used.
Symptoms of esophageal cancer unfortunately occur only in the later stages and this is the reason why esophageal cancer survival rates are very poor, even with aggressive treatment. The esophagus has a lot of blood supply meaning that it has also a lot of lymphatic drainage to other surrounding organs. This complicates the clinical course in the later stages of the disease through spread of metastases via these pathways. On the other hand we know from studies, where high risk patients were observed by repeat esophagus endoscopies over several years, that it often takes 3 to 4 years for a suspicious precancerous lesion to turn cancerous.
References:
1. Cancer: Principles &Practice of Oncology.4th edition. Edited by Vincent T. DeVita, Jr. et al. Lippincott, Philadelphia,PA, 1993. Chapter 25. Cancer of the esophagus.
2. Cancer: Principles&Practice of Oncology. 5th edition, volume 1. Edited by Vincent T. DeVita, Jr. et al. Lippincott-Raven Publ., Philadelphia,PA, 1997. Cancer of the esophagus.
3. D Sharma J Indian Med Assoc 1999 Sep;97(9): 360-364.
4. MJ Roth et al. Cancer Res 2001 May 15;61(10):4098-4104.
5. K Schumacher et al. Cancer Res 2001 May 15;61(10):3932-3936.
6. M Tachibana et al. Virchows Arch 2001 Apr;438(4):350-356.
7. SJ Spechler et al. JAMA 2001 May 9;285(18):2331-2338.
